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Pain alleviation in patients undergoing cardiac surgery; presternal local anesthetic and magnesium infiltration versus conventional intravenous analgesia: a randomized double-blind study
The Korean Journal of Pain ; : 93-101, 2018.
Article in English | WPRIM | ID: wpr-742179
ABSTRACT

BACKGROUND:

Magnesium is one of the effective, safe local anesthetic adjuvants that can exert an analgesic effect in conditions presenting acute and chronic post-sternotomy pain. We studied the efficacy of continuous infusion of presternal magnesium sulfate with bupivacaine for pain relief following cardiac surgery.

METHODS:

Ninety adult patients undergoing valve replacement cardiac surgery randomly allocated into three groups. In all patients; a presternal catheter was placed for continuous infusion of either 0.125% bupivacaine and 5% magnesium sulfate (3 ml/h for 48 hours) in group 1, or 0.125% bupivacaine only in the same rate in group 2, versus conventional intravenous paracetamol and ketorolac in group 3. Rescue analgesia was iv 25 µg fentanyl. Postoperative Visual Analog Scale (VAS) and fentanyl consumption during the early two postoperative days were assessed. All patients were followed up over two months for occurrence of chronic post-sternotomy pain.

RESULTS:

VAS values showed high significant differences during the first 48 hours with the least pain scale in group 1 and significantly least fentanyl consumption (30.8 ± 7 µg in group 1 vs. 69 ± 18 µg in group 2, and 162 ± 3 in group 3 respectively). The incidence of chronic pain has not differed between the three groups although it was more pronounced in group 3.

CONCLUSIONS:

Continuous presternal bupivacaine and magnesium infusion resulted in better postoperative analgesia than both presternal bupivacaine alone or conventional analgesic groups.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Thoracic Surgery / Bupivacaine / Fentanyl / Double-Blind Method / Incidence / Ketorolac / Catheters / Chronic Pain / Visual Analog Scale / Analgesia Type of study: Controlled clinical trial / Incidence study / Prognostic study Limits: Adult / Humans Language: English Journal: The Korean Journal of Pain Year: 2018 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Thoracic Surgery / Bupivacaine / Fentanyl / Double-Blind Method / Incidence / Ketorolac / Catheters / Chronic Pain / Visual Analog Scale / Analgesia Type of study: Controlled clinical trial / Incidence study / Prognostic study Limits: Adult / Humans Language: English Journal: The Korean Journal of Pain Year: 2018 Type: Article